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Only because they can be, if hospitals and law-makers meet in the middle come up w/ across the industry iron-clad rates for services, or hell -- what if hospita
by gremlinsinc 8y ago
Only because they can be, if hospitals and law-makers meet in the middle come up w/ across the industry iron-clad rates for services, or hell -- what if hospitals just get a flat average monthly lump sum -- no piecemeal at all, just based on # of patients that go through their door in a month?
Dr's get x% based on patients they saw + hours booked in the OR. Hospital administrators would have pay caps of 1 million per year. Hospitals that struggle could get grants and loans while the system corrects and adjusts to pay them more so they meet their budget constraints.
- nradov 8y agoYes capitation is already being tried in some areas as one approach to shifting the market from a fee-for-service model to value-based care. However provider organizations still struggle with it because most lack the data, tools, and expertise to properly price the risk. Medicare administrators and lawmakers already do set iron-clad rates for service. The rates are relatively low, which is why there's a shortage of doctors willing to treat Medicare patients. And being nitpicky on claims isn't so much a matter of pricing. Instead the insurers are trying to prevent waste, fraud, and abuse.